Apr 2 Measles Outbreak: To Vaccinate or Not to Vaccinate

An outbreak of measles is currently underway throughout Europe, with infection rates exacerbated by low immunization levels. Italy has seen over 200 cases while Romania has been hit the hardest, witnessing over 3,400 cases and 17 deaths in the past year. People all over the continent are at risk of contracting the disease due to frequent travel and the highly contagious nature of measles. The incidence of the disease is continuing to grow in 2017, especially in areas with weaker vaccination coverage.

The World Health Organization (WHO) recommends that all children be vaccinated against measles within the first few years of life. Vaccination typically comes in the form of two doses of an MMR vaccine, containing reduced strains of measles, mumps, and rubella, and is expected to confer immunity to approximately 95% of recipients [1]. Adolescents or adults who did not receive the vaccine as infants can still gain immunity against measles through vaccination. Currently, the WHO’s recommended level of vaccination is 95% of the population. At this level, populations are expected to develop herd immunity, meaning even those that aren’t vaccinated are essentially protected against the disease because there is such a slim chance of an outbreak occurring within the heavily-guarded community. When vaccination levels slip below 95%, herd immunity wavers and outbreaks start to spring up. Such a drop can occur for a variety of reasons. In the Ukraine, lack of medical resources has led to a simple inability to provide enough vaccines to a sufficient number of people. Elsewhere, “some people are fearful of vaccination, while others are complacent or find it an inconvenience” [2].

In Romania in particular, vaccination levels have indeed dropped significantly. Current data from Romania shows that “coverage for one dose was just 86% in 2015… compared with 97% in 2007” [3]. The medical community is responding to the best of its ability. Warnings have been issued to individuals traveling to and from Romania, and there has also been a significant circulation of educational materials regarding recommendations for vaccination. Furthermore, Romania “lowered the age of the first MMR vaccine dose from 12 months to 9 months” and is actively “registering unvaccinated children for vaccination” [3].

The question of whether or not eligible individuals should be pressured, or perhaps even forced, to be vaccinated has been a popular topic of debate in recent years. In 1997, Andrew Wakefield published a study pointing to the MMR vaccine as the reason behind growing rates of autism. Despite Wakefield’s paper being discredited due to several serious sources of error, his conclusion took a foothold in society, and a relatively widespread fear of vaccination is still at large today. Further research on a possible link between the MMR vaccine and autism has failed to find any valid connection, and there is even evidence to suggest “that autism develops in utero, well before a baby is born or receives vaccinations” [4].

With the lack of scientific evidence linking vaccines to negative health consequences and the rise in disease outbreaks similar to the one currently spreading through Europe, it is simply irresponsible for individuals to refrain from vaccination out of fear of its imagined harmful effects. While it may seem as though one couple choosing not to vaccinate their children is limited in its potential consequences, when multiple families make the same decision it poses a serious threat to herd immunity. There is a common claim that those who opt out of vaccination are only increasing the danger to themselves, and therefore have a right to make that decision. In reality, the implications of choosing not to vaccinate impact more people than just the individual.

Certain people are ineligible to receive certain vaccines, and are therefore at the mercy of the decisions made by those around them. Allergies and pregnancy, amongst other medical conditions, can result in the MMR vaccine causing more harm than benefit to certain people, who are left with no options other than to stay as healthy as possible and hope that the disease does not arise within their community. These are the very people that suffer when vaccination levels drop and herd immunity starts to fade. If you are ineligible for the MMR vaccine and your neighbor chooses not to vaccinate their child, you could be directly affected by their decision. Consequently, individuals resisting vaccination are making decisions with ramifications that extend much further than their own health.

If evidence existed that pointed to vaccines as a genuine cause of autism, resistance to vaccination would be understandable, and perhaps even encouraged. However, that evidence does not exist. If people continue to question the safety of vaccination, outbreaks like the one in Romania will become more frequent and more deadly, and many people do not have the ability to protect themselves from such disasters. In order to enforce vaccination at the level recommended by the WHO, legislative action is most likely necessary, considering many people are resistant to scientific evidence regardless of its proven validity. It is probable that such legislative action will be seen as paternal and overreaching, but it is surely required in order to promote the safety of people ineligible for certain vaccines.

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